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Individual

MARK REHORST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
6226 14TH AVE, KENOSHA, WI 53143-4413
(262) 656-0044
(262) 654-9333
Mailing address
625 57TH ST, SUITE 700, KENOSHA, WI 53140-4146
(262) 656-0044
(262) 654-9333

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6807-15
WI

Other

Enumeration date
12/28/2011
Last updated
12/28/2011
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